Opioid Use and Respiratory Compromise in the Interventional Suite: A Wake-up Call
UMass Chan Affiliations
Department of Anesthesiology and Perioperative MedicineDepartment of Radiology
Document Type
EditorialPublication Date
2019-09-01Keywords
Chemical Actions and UsesRadiology
Respiratory System
Respiratory Tract Diseases
Substance Abuse and Addiction
Therapeutics
Metadata
Show full item recordAbstract
The study by Urman et al (1) in this issue of Radiology addresses the effect of respiratory compromise among inpatients undergoing interventional radiology (IR) procedures performed with moderate sedation. The study was conducted by using a national all-payer database and included data from over 500 000 patients across 853 hospitals, collected during a 3-year period. The results demonstrated that, among a wide range of variables, long-term opioid therapy or active substance abuse were the strongest predictors of respiratory compromise, with an odds ratio (OR) of 2.7. This is almost twice that of the second strongest predictors: age 65 years or older (OR, 1.4) and sleep apnea (OR, 1.3). The reason for the significant association between long-term opioid therapy or active substance abuse and sleep apnea with periprocedural respiratory complications is likely twofold: A larger dose of sedative and analgesic drugs is required to achieve an adequate level of sedation in patients who are administered long-term opioid therapy or with substance use disorder, and this may result in unintended deep, rather than moderate, sedation. Furthermore, there is evidence for a higher periprocedural risk of respiratory compromise following procedural sedation in patients with sleep apnea. The latter is important because the prevalence of sleep apnea in the general population is on the rise (2). Patients with respiratory compromise incurred statistically higher costs, longer hospital stays, and higher rates of intensive care unit admission, need for mechanical ventilation, and death.Source
Radiology. 2019 Sep;292(3):711-712. doi: 10.1148/radiol.2019191173. Epub 2019 Jul 2. Link to article on publisher's site
DOI
10.1148/radiol.2019191173Permanent Link to this Item
http://hdl.handle.net/20.500.14038/48380PubMed ID
31268838Related Resources
ae974a485f413a2113503eed53cd6c53
10.1148/radiol.2019191173